R:Chapter 69: The High-Risk Newborn

The nurse performs risk assessments on clients who are pregnant. Which of the following pregnant women would be most at risk for having a baby with Down syndrome? A) A pregnant woman over 40 years of age B) A pregnant woman who smokes tobacco during pregnancy C) A pregnant woman who drinks alcohol during pregnancy D) A pregnant woman who experiences a threatened abortion

A) A pregnant woman over 40 years of age

When assessing the condition of a 3-day-old preterm baby girl, an attending nurse notices that the baby exhibits a limitation of abduction on the right side when the thigh is flexed. Which of the following conditions should the nurse suspect in the child? A) Congenital dislocated hip B) Talipes C) Polydactylism D) Syndactylism

A) Congenital dislocated hip

The nurse assessing a newborn in the NICU documents the following data for this client: weight: 4.5 lb, gestation: 35 weeks. How would the nurse classify this newborn? A) Low birth weight, preterm B) Low birth weight, term C) Very low birth weight, preterm D) Very low birth weight, term

A) Low birth weight, preterm

A 35-year-old client has just given birth to a healthy newborn during her 43rd week of gestation. Which of the following should the nurse expect when assessing the condition of the newborn? A) Meconium aspiration in utero or at birth B) Seizures, respiratory distress, cyanosis, and shrill cry C) Yellow appearance of the newborn's skin D) Tremors, irritability, and high-pitched cry

A) Meconium aspiration in utero or at birth

The nurse caring for newborns on an obstetrical ward assesses a SGA newborn. What characteristics are typical for this classification of newborn? Select all that apply. A) Poor skin turgor B) Tight and moist skin C) Sparse or absent hair D) Narrow skull sutures E) Diminished muscle tissue F) Increased fatty tissue

A) Poor skin turgor C) Sparse or absent hair E) Diminished muscle tissue

A newborn is being monitored for retinopathy of prematurity. Which of the following conditions predisposes an infant to this condition? A) Respiratory distress syndrome B) Down syndrome C) Hydrocephalus D) Esophageal artresia

A) Respiratory distress syndrome

The nurse assessing a newborn with Rh sensitization explains the disorder to the parents. Which of the following accurately describes this condition? A) The disease occurs when an Rh-negative mother is pregnant with an Rh-positive fetus. B) The disease occurs from the first pregnancy on to subsequent pregnancies. C) The disease causes the woman's antibodies to destroy fetal white blood cells. D) The only treatment for the disease is performing an intrauterine transfusion.

A) The disease occurs when an Rh-negative mother is pregnant with an Rh-positive fetus.

A 20-year-old client gave birth to a baby boy during the 43rd week of gestation. Which of the following might the nurse observe in the newborn during routine assessment? A) The newborn may look wrinkled and old at birth. B) The infant may have excess of lanugo and vernix caseosa. C) The testes in the child may be undescended. D) The newborn may have short nails and hair.

A) The newborn may look wrinkled and old at birth.

The nurse is teaching the parents of a newborn diagnosed with atrial septal defect the etiology of this disorder. Which of the following statements accurately describes this condition? A) "Your baby's ductus arteriosus in the heart failed to close at birth." B) "There are abnormal openings between your baby's heart chambers." C) "Four major heart defects have occurred simultaneously in your baby's heart." D) "Your baby's aorta narrows as it leaves the heart."

B) "There are abnormal openings between your baby's heart chambers."

The nurse is providing teaching for the mother of a male neonate diagnosed with talipes. Which of the following statements reflects a teaching point for this disorder? A) "Your son will undergo surgery to have shunts placed in his head to drain fluid." B) "Your son will be fitted with corrective shoes and may eventually need surgery." C) "Your son will wear a 'triple diaper' to force his leg into abduction." D) "Your son will have a suture tied around his extra finger until it falls off."

B) "Your son will be fitted with corrective shoes and may eventually need surgery."

The nurse is performing a physical assessment on a newborn diagnosed with galactosemia. Which of the following are signs present in newborns with this disorder? Select all answers that apply. A) Cyanosis B) Jaundice C) Mental retardation D) Heart defects E) Vomiting F) Urinary retention

B) Jaundice C) Mental retardation E) Vomiting

An 18-year-old client has given birth to a very-low-birth-weight preterm infant. Which of the following should the nurse consider to prevent the newborn from losing body temperature? A) Hold the newborn close, rocking gently. B) Provide isolette care to the newborn. C) Administer vitamin K to the newborn. D) Give the newborn a warm water bath.

B) Provide isolette care to the newborn.

The nurse caring for high-risk newborns knows that infections that are present in the woman during pregnancy or delivery can adversely affect her fetus. The nurse uses the acronym TORCH as a reminder of the most serious infections. Which of the following infections are represented by this acronym? Select all that apply. A) Tuberculosis B) Syphilis C) Hepatitis D) Cytomegalovirus E) Measles F) Herpes simplex virus

B) Syphilis C) Hepatitis D) Cytomegalovirus F) Herpes simplex virus

The nurse is caring for a newborn who is diagnosed with hypoglycemia. Which of the following is a typical sign of this condition? A) Lethargy B) Tremors C) Jaundice D) Overeating

B) Tremors

For which of the following newborns would immediate surgery be necessary to save the baby's life? A) A newborn with pyloric stenosis B) A newborn with esophageal atresia C) A newborn with tracheoesophageal fistula D) A newborn with imperforate anus

C) A newborn with tracheoesophageal fistula

When assessing the health of a preterm baby born through a difficult delivery, the nurse notices that the baby is unable to elevate the right arm, which lies limply at his side. The grasp reflex is found to be present in the infant. Which of the following does the nurse suspect in the child, possibly as a result of trauma during birth? A) Fractured clavicle B) Intracranial hemorrhage C) Brachial plexus injury D) Bell's palsy

C) Brachial plexus injury

When assessing a preterm newborn, the nurse observes that the newborn has difficulty breathing. On further examination, it is found that the newborn's nostrils are closed at the entrance to the throat. Which of the following conditions does this suggest? A) Pyloric stenosis B) Respiratory distress syndrome C) Choanal atresia D) Patent ductus arteriosus

C) Choanal atresia

The nurse is assessing a newborn and notes the skin has a dusky, blue color. What condition would the nurse suspect? A) Jaundice B) Dehydration C) Cyanosis D) Hypoglycemia

C) Cyanosis

The nurse in the NICU is caring for preterm newborns. Which of the following are recommended guidelines for care of these newborns? Select all that apply. A) Handle the newborn as much as possible. B) Give the newborn a warm bath immediately. C) Dress the newborn in a stockinette cap. D) Take the newborn's temperature often. E) Supply oxygen for the newborn, if necessary. F) Discourage contact with parents to maintain asepsis.

C) Dress the newborn in a stockinette cap. D) Take the newborn's temperature often. E) Supply oxygen for the newborn, if necessary.

The nurse is caring for a newborn with transient tachypnea of the newborn (TTN). Which of the following is a typical nursing intervention for this condition? A) Providing continuous positive airway pressure treatments B) Administering IV antibiotics C) Giving supplemental oxygen as per the health provider's order D) Administering exogenous surfactant by ET tube

C) Giving supplemental oxygen as per the health provider's order

A nurse is observing a neonate diagnosed with Bell's palsy. Which of the following signs will the nurse notice in the newborn? A) Paralysis of both sides of the face B) Seizures and respiratory distress C) Impairment of the sucking mechanism D) Drooping of both the eyelids

C) Impairment of the sucking mechanism

During the assessment of a preterm newborn, the attending nurse notices a soft bulging on the infant's back. On further examination, it is found that the child has a herniation of spinal cord nerve fibers and meninges. Which of the following explains this condition? A) Anencephaly B) Hydrocephalus C) Myelomeningocele D) Down syndrome

C) Myelomeningocele

A nurse is caring for a low-birth-weight baby with phenylketonuria. Which of the following should the nurse keep in mind when providing nursing care for the child? A) The condition can be cured with medications. B) The condition is caused by maternal viral infections. C) The condition, if untreated, can lead to mental impairment. D) The condition is a result of defective fat metabolism.

C) The condition, if untreated, can lead to mental impairment.

The nurse assessing a newborn after a difficult delivery suspects that the baby may have sustained a fractured clavicle. Which of the following signs would alert the nurse to this condition? A) Seizures B) Erb-Duchenne paralysis C) Cyanosis D) Asymmetrical Moro's reflex

D) Asymmetrical Moro's reflex

The nurse is caring for a newborn who is cocaine dependent. Which of the following is a recommended guideline for handling the baby? A) Do not make eye contact with the baby. B) Touch the baby gently. C) Rock the baby side to side. D) Avoid unnecessary handling of the baby.

D) Avoid unnecessary handling of the baby.

The nurse is caring for a large-for-gestational-age newborn (also known as macrosomia). What maternal condition is the usual cause of this condition? A) Alcohol use B) Hypertension C) Celiac disease D) Diabetes

D) Diabetes

The nurse is delivering a lecture on proper nutrition to pregnant women attending a prenatal class. What nutrient would the nurse strongly recommend to reduce the risk of neural tube defects in their babies? A) Magnesium B) Vitamin D C) Calcium D) Folic acid

D) Folic acid

A baby is born to a mother who has gonorrhea. What intervention must the nurse perform soon after birth to prevent complications? A) Isolate the baby and administer penicillin. B) Isolate the baby and administer nystatin. C) Ensure adequate respiration. D) Instill antibiotic ointment into the eyes.

D) Instill antibiotic ointment into the eyes.

The nurse teaches pregnant women that maternal use of alcohol is a major factor contributing to fetal physical defects and as little as 1 ounce a day can adversely affect the fetus. Which of the following is an adverse affect of maternal alcohol use? A) Large for gestational age newborn B) Stillbirth C) Seizures D) Mental retardation

D) Mental retardation

A 3-day-old preterm infant is diagnosed with physiologic jaundice. When subjecting the newborn to phototherapy, to which of the following must the nurse pay attention? A) Encouraging frequent maternal-child bonding B) Avoiding frequent feeding of the newborn C) Wrapping the infant in warm clothes D) Preventing hypothermia or hyperthermia

D) Preventing hypothermia or hyperthermia